Literature DB >> 28921241

Evaluating the efficacy of vaginal dehydroepiandosterone for vaginal symptoms in postmenopausal cancer survivors: NCCTG N10C1 (Alliance).

Debra L Barton1, Jeff A Sloan2, Lynne T Shuster3, Paula Gill3, Patricia Griffin4, Kathleen Flynn5, Shelby A Terstriep6, Fauzia N Rana7, Travis Dockter2, Pamela J Atherton2, Michaela Tsai8, Keren Sturtz9, Jacqueline M Lafky3, Mike Riepl10, Jacqueline Thielen3, Charles L Loprinzi3.   

Abstract

BACKGROUND: Women with estrogen deficiencies can suffer from vaginal symptoms that negatively impact sexual health. This study evaluated vaginal dehydroepiandrosterone (DHEA) for alleviation of vaginal symptoms.
METHODS: This three-arm randomized, controlled trial evaluated DHEA 3.25 mg and DHEA 6.5 mg, each compared to a plain moisturizer (PM) over 12 weeks, to improve the severity of vaginal dryness or dyspareunia, measured with an ordinal scale, and overall sexual health using the Female Sexual Function Index (FSFI). Postmenopausal women with a history of breast or gynecologic cancer who had completed primary treatment, had no evidence of disease, and reported at least moderate vaginal symptoms were eligible. The mean change from baseline to week 12 in the severity of vaginal dryness or dyspareunia for each DHEA dose was compared to PM and analyzed by two independent t tests using a Bonferroni correction.
RESULTS: Four hundred sixty-four women were randomized. All arms reported improvement in either dryness or dyspareunia. Neither DHEA dose was statistically significantly different from PM at 12 weeks (6.25 mg, p = .08; 3.25 mg, p = 0.48), although a significant difference at 8 weeks for 6.5 mg DHEA was observed (p = 0.005). Women on the 6.5 mg arm of DHEA reported significantly better sexual health on the FSFI (p < 0.001). There were no significant differences in provider-graded toxicities and few significant differences in self-reported side effects.
CONCLUSION: PM and DHEA improved vaginal symptoms at 12 weeks. However, vaginal DHEA, 6.5 mg, significantly improved sexual health. Vaginal DHEA warrants further investigation in women with a history of cancer.

Entities:  

Keywords:  DHEA; Sexual health; Vaginal symptoms; Women

Mesh:

Substances:

Year:  2017        PMID: 28921241      PMCID: PMC5754227          DOI: 10.1007/s00520-017-3878-2

Source DB:  PubMed          Journal:  Support Care Cancer        ISSN: 0941-4355            Impact factor:   3.603


  29 in total

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Authors:  Rosemary Basson
Journal:  Womens Health (Lond)       Date:  2010-05

3.  Intravaginal prasterone (DHEA) provides local action without clinically significant changes in serum concentrations of estrogens or androgens.

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4.  Predictors of sexual health in women after a breast cancer diagnosis.

Authors:  P A Ganz; K A Desmond; T R Belin; B E Meyerowitz; J H Rowland
Journal:  J Clin Oncol       Date:  1999-08       Impact factor: 44.544

5.  Effect of intravaginal dehydroepiandrosterone (Prasterone) on libido and sexual dysfunction in postmenopausal women.

Authors:  Fernand Labrie; David Archer; Céline Bouchard; Michel Fortier; Leonello Cusan; José-Luis Gomez; Ginette Girard; Mira Baron; Normand Ayotte; Michèle Moreau; Robert Dubé; Isabelle Côté; Claude Labrie; Lyne Lavoie; Louise Berger; Lucy Gilbert; Céline Martel; John Balser
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6.  Predictors of sexual functioning in ovarian cancer patients.

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7.  Intravaginal dehydroepiandrosterone (Prasterone), a physiological and highly efficient treatment of vaginal atrophy.

Authors:  Fernand Labrie; David Archer; Céline Bouchard; Michel Fortier; Leonello Cusan; José-Luis Gomez; Ginette Girard; Mira Baron; Normand Ayotte; Michèle Moreau; Robert Dubé; Isabelle Côté; Claude Labrie; Lyne Lavoie; Louise Berger; Lucy Gilbert; Céline Martel; John Balser
Journal:  Menopause       Date:  2009 Sep-Oct       Impact factor: 2.953

8.  Serum steroid levels during 12-week intravaginal dehydroepiandrosterone administration.

Authors:  Fernand Labrie; David Archer; Céline Bouchard; Michel Fortier; Leonello Cusan; José-Luis Gomez; Ginette Girard; Mira Baron; Normand Ayotte; Michèle Moreau; Robert Dubé; Isabelle Côté; Claude Labrie; Lyne Lavoie; René Bérubé; Patrick Bélanger; Louise Berger; Lucy Gilbert; Céline Martel; John Balser
Journal:  Menopause       Date:  2009 Sep-Oct       Impact factor: 2.953

9.  Responsiveness and minimal important differences for patient reported outcomes.

Authors:  Dennis A Revicki; David Cella; Ron D Hays; Jeff A Sloan; William R Lenderking; Neil K Aaronson
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10.  Quality of life and sexual function after high-dose or conventional chemotherapy for high-risk breast cancer.

Authors:  K M Malinovszky; A Gould; E Foster; D Cameron; A Humphreys; J Crown; R C F Leonard
Journal:  Br J Cancer       Date:  2006-12-18       Impact factor: 7.640

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Journal:  Gynecol Oncol       Date:  2020-06-08       Impact factor: 5.482

Review 2.  Reproductive health care across the lifecourse of the female cancer patient.

Authors:  Lisa A Rubinsak; Mindy S Christianson; Aletha Akers; Jeanne Carter; Andrew M Kaunitz; Sarah M Temkin
Journal:  Support Care Cancer       Date:  2018-07-26       Impact factor: 3.603

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Journal:  Gland Surg       Date:  2018-08

4.  Factors associated with worsening sexual function during adjuvant endocrine therapy in a prospective clinic-based cohort of women with early-stage breast cancer.

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Journal:  Breast Cancer Res Treat       Date:  2022-10-05       Impact factor: 4.624

5.  Efficacy and Safety of Treatments to Improve Dyspareunia in Breast Cancer Survivors: A Systematic Review.

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Journal:  Breast Care (Basel)       Date:  2020-02-24       Impact factor: 2.860

Review 6.  Practical Treatment Considerations in the Management of Genitourinary Syndrome of Menopause.

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Journal:  Drugs Aging       Date:  2019-10       Impact factor: 3.923

7.  Effects of local laser treatment on vulvovaginal atrophy among women with breast cancer: a prospective study with long-term follow-up.

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Review 9.  Interventions to Improve Sexual Health in Women Living with and Surviving Cancer: Review and Recommendations.

Authors:  Jenna Sopfe; Jessica Pettigrew; Anosheh Afghahi; Leslie C Appiah; Helen L Coons
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